This invention relates to methods of neurologic examination for the diagnosis and staging of the severity of dementia. The invention further relates to a method of diagnosis based upon generalized cortical, frontal and other neurologic signs.
The use of conventional neurologic examination techniques as early indicators and predictors of dementia and its progress has not been successful. Presently, dementia is diagnosed and staged by using clinical assessments of cognitive and functional capacity. For example, there are global clinical staging measures such as the Global Deterioration Scale (Reisberg, B., Ferris, S.H., de Leon, M.J. and Crook, T., 1982), the Blessed Dementia Scale and Information-Memory-Concentration Test (Blessed, G., Tomlinson, B.E. and Roth, M., 1968) and the Alzheimer's Disease Assessment Scale (ADAS) (Rosen, W., Mohs, R. and Davis, K., 1984). There are mental status assessments such as the Mini Mental State (Folstein, M.F., Folstein, S.E. and Mc Hugh, P.R., 1975), and various psychological tests such as the Auild Memory Test (Gilbert, J.G. and Levee, R.F., 1971), and the Boston Naming Test (Goodglass, H., Kaplan, E. and Weintraub, S., 1976).
All of these measurements are of limited utility in part because they depend upon the educational attainment, intelligence and skill of the subject for early diagnosis. These factors and the magnitude of cooperation can also influence staging. None of these measures are useful for staging severe dementia (Mohs, R., Kim, Y., Johns, c., Dunn, D. and Davis, K., 1986 ; Wilson, R.E., Kazniak, A., 1986; Reisberg, B., Ferris, S.H., de Leon, M.J. et al., 1988). Also, these measures are only a very indirect result of the actual brain changes occurring in dementia. We therefore developed the present invention of a cognition-independent system for early dementia diagnosis and staging.
Reflex phenomena such as deep tendon reflexes, paratonic muscle rigidity, and primitive reflexes (syn. release signs) have been studied in dementia, either individually or within the context of a clinical neurological examination. They have, however, not been used in a system to diagnose or stage dementia.